Round the clock community nursing services should be available everywhere to support patients nearing the end of their life, according to an independent review commissioned by the government into the way palliative care is funded.
The Palliative Care Funding Review, published last week, proposed introducing a specific pot of money to pay for the needs of all patients nearing end of life to allow more to die at home rather than hospital. This is in line with the aims of the 2008 End of Life Care Strategy.
The review, chaired by Marie Curie Cancer Care chief executive Thomas Hughes-Hallett, recommended the tariff funded an initial assessment of patient needs based on their stage of illness – classified as stable, deteriorating and dying – with regular follow ups; a coordinator to advise them on available services; and free social care.
It also called for community services to be “built up” to provide 24/7 access for all to community nursing care, which it said was crucial to enable people to be cared for at home. A 2010 Macmillan Cancer Support survey found 24-hour community nursing was only fully available in 56% of primary care trusts.
The review said “a relatively small investment” in 24/7 community services now would deliver improved outcomes and ensure palliative care was delivered “in the most cost effective way”.
It said introducing its tariff system and investing in community services could potentially cut deaths in hospital settings by 60,000 each year by 2012, saving an estimated £180m per annum.
Macmillan Cancer Support chief executive Ciarán Devane said 24/7 community nursing services were “crucial to the delivery of choice” for patients.
“It is now up to the government to incentivise commissioners to provide these services as standard across the country,” he said. “We need to see a massive improvement.”